Korean Journal of Gastrointestinal Endoscopy 1999;19(3): 491-496.
부유두 내 췌관 배액관 삽입술 및 부유두 괄약근 절개술로 호전된 만성 췌장염 1 예 ( One Case of Endoscopic Stenting with Minor Papilla Sphincterotomy in a Patient with Chronic Pancreatitis )
정인섭, 문종호, 조영덕, 조주영, 김연수, 이준성, 이문성, 심찬섭 (In Seop Jung, Jong Ho Moon, Young Deok Cho, Joo Young Cho, Yun Soo Kim, Joon Seong Lee, Moon Sung Lee and Chan Sup Shim)
Abstract
The anatomy of the pancreatic ducts and their variations are best defined through a pancreatography, which is especially useful for determining the appropriate endoscopic management. Pressure in the pancreatic ductal system has been shown to be significantly higher in patients with painful chronic pancreatitis and dilated ducts when compared with pressure in controls. The aim of pancreatic drainage procedures is to improve the outflow of pancreatic juice, thereby lowering intraductal pressure and affording relief of pain. It is necessory for both endoscopic pancreatic sphincterotomy (EPS) and stenting have to be performed at the papilla of the dominant duct, which is the Wirsung duct (embryologic "ventral" duct), in the majority such of cases. An EPS of the minor papilla should be considered when the duct of Santorini (embryologic "dorsal" duct) predominates, as in patients with complete or incomplete divided ducts or with a distorted connection between the ventral and the dorsal duct. In these patients, access to the main pancreatic duct (MPD) is easier through the duct of Santorini. A 42 year-old man was admitted with chronic recurrent pancreatitis. Minor papilla sphincterotomy and endoscopic stent placement were performed for the drainage of the dorsal pancreatic duct. After stenting of the minor papilla, abdominal pain disappeared and pancreatitis did not develop after a 7 month follow-up, the stent was changed. (Korean J Gastrointest Endosc 19: 491∼496, 1999)
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